Thursday, January 15, 2015

Lower Back Pain?


It's been nearly 30 years that I have been climbing under horses for a living, and I am happy to say that I don't suffer from back issues. So why the post title? Well I thought that the title would catch the attention of more of you.
The truth is that I do get lower back pain now and again, but I have come to realize that it is actually kidney pain. No, I don't have kidney disease.
What I do have are bad habits, and the worst habit I have is that ignoring the signs. What signs am I talking about? The signs that point to me being dehydrated, the signs that say I've had to much caffeine, and the signs that say I haven't had enough sleep.

Follow this link for more information on avoiding kidney pain.

10 Common Habits that Damage Your Kidneys

Do you do CPD? Continued Profesional Development

Time is money, and in today's fast paced world many are finding it difficult to justify parting with either money or time. In the world of hoof care this has never been more true. Whenever the economy suffers it is those industries that serve the nonessential that are hit most and we have to face the truth, horses are no longer essential to survival for most. Ouch, that hurts. The horse is essential to those of us that make our living caring for them. But the facts remain, the horse industry pulls harder on its purse strings than many other industries when times are tough. As a result, as professional care providers we are forced to work more hours, do more horses, and spend less time away doing things that are not putting money in the bank. Where does continuing education fit in? A few years ago I was asked by the publisher of the American Farrier Journal to comment on how our graduates, and our school was coping with the down turned economy. Here is the short response I sent them.

Implementing Aggressive Business Strategies

In an effort to ride out the current economy, we have had to integrate into our curriculum, new education on strong, ethical business practices and professional communication. To better support our graduates and students we succeeded in becoming an approved provider of continuing education for the American Association of Veterinary State Boards. Our programs represent from 15 to 60 hours of continuing education. Our new programs include on-line modules on team building and communication.

KC La Pierre lectures at 2006 IHS Ohio

It has become clear that today's horse owner is more likely to be proactive in their approach to hoof care, and as a result actively seek out those hoof care providers that participate in continuing education. At the Institute we actively promote those graduates that meet the Institute's yearly CPD requirement of (40 hours). Promotion consists of web site promotion, articles distribution, presence at major equine events worldwide and television exposure.

We have found that those graduates that have developed the communication skills necessary to work closely with veterinarians are excelling in business, even during this economic turmoil.

I believe it can be summed up by saying that today's hoof care provider has to have good communication skills, and the knowledge to support those skills. In today's economy the hoof care provider needs to be a hoof care professional that cannot only talk the talk, but also walk the walk; today's horse owner demands it. 
Teaching anatomy (Cambridge University, UK 2003)

Remember ... Sound Reasoning - Sound Horses 


Having seen a recent post on face book in a popular farrier group asking what farriers did for CPD inspired me to write this blog post. 
Comments in that group ranged from ride along with vets and more experienced farriers to attending conferences. But what I found interesting was that there was no cohesiveness to those post. Most of the farriers that were doing ride alongs were relatively inexperienced and could spend the time, as they did not have a huge demanding clientele. Conference attendance did not appear to be yearly, and workshop or clinic attendance was limited to "when there is one close enough". 
It remains that CPD is not a requirement for the farrier, and that is okay. Why is that okay? When CPD is not a requirement those that seek out CPD are those that benefit most from it. Continuing Professional Development is not simply about staying current, it is about staying ahead. 
That being said, it is fact that attendance to many of the farrier and veterinary conference has shown huge declines in recent years. Is it simply the economy? It could be, but it may also be that potential attendees are not convinced that what conferences offer for CPD has value. CPD needs to offer the kind of information that will help the attendee help more horses, offer ideas that will ultimately save the attendee time and money. CPD must be viewed as a tool that will pay for itself in the long run. Those that do offer CPD are competing for the attendees time and money. There is only so much of either available to the prospective attendee. There are hundreds of CPD opportunities available to today's farrier, but which one too choose? That really comes down to the goals they set for themselves. 
Are you looking to expand on your knowledge of anatomy or bio mechanics, improve your tools skills, or perhaps your communication skills ? Some farriers simply enjoy the social aspect of the event, still others go with specific questions in mind that they seek answers for. What ever the reason is for attending a conference or workshop, choose one that speaks to your individual needs. Don't simply go with the flow because its easier to move with the crowd than to stay ahead of it. Spend your time and money wisely, it is no longer a matter of simply checking the attendance box. Your clients are well educated and you need to be as well. 

We are upping the number of CPD offerings to our graduates, farriers, and veterinarians. There will be over 12 courses and workshops offered in the USA in 2015 and 8 offered abroad. We are adding several "Balance" workshops to our calendar this year, one day workshops offered to certified farriers, DAEP, and Veterinarians. In this course emphasis is placed on ways to achieve consistent and repeatable dynamic balance of the hoof. 
After nearly 15 years of teaching Applied Equine Podiatry I understand that it is not for everyone, but for those interested in keeping ahead of the curve in this every changing industry adding an AEP workshop to your CPD list may prove to be beneficial. A recent Connecticut court decision involving the practice of podiatry and veterinary medicine stated that Equine Podiatry is an evolution of the Farrier trade, are you game for change?

Wednesday, January 14, 2015

New Veterinary Equine Podiatry Group

Newly formed group looks to organize and define Equine Podiatry as it refers to the Veterinary Practices.
According to VEPG chairman Mark Silverman, MS, DVM of Sport Horse Veterinary Practice in Rancho Santa Fe, California, the group exists for the express purpose of setting a standard for the qualifications and role of a veterinary equine podiatrist. 
Unlike other countries, in the United States each state is responsible for establishing its own veterinary practice laws and qualifications. There have been many attempts to regulate farriers through state veterinary regulation. Is that the goal of this group? I personally think developing a board certification for Equine Podiatry is a good idea, But the facts may show that demand will out weigh the number of veterinarians willing to become board certified. Our horses do deserve to have the best podiatry care available, but when the number of horses needing help out number the available care providers, what then? As it is there are very few veterinarians that want to do farrier work. I think the greater need is for education at the the farrier level, education that will allow the farrier and veterinarian to work together.  Follow this link for a more information.

Hoof Testers "How To"

The subject of hoof testers comes up frequently among farriers and veterinarians. I recall teaching an equine podiatry electives course at Cambridge University in the United Kingdom many years ago with a dozen sixth year veterinarian students in attendance. They were very interested in learning about the foot's anatomy, but what really peaked their interest was learning how to use hoof testers properly. Apparently they were under the impression that many vets suffered back injuries from not positioning themselves correctly under the horse while using hoof testers. This post is not about getting under the horse correctly, but it is very important that you do get under the horse when using testers. It is difficult to feel response if you are holding the hoof with one hand and the testers with the other. You need to be under the horse with the limb in the correct trimming position, so that you may use both hands on the testers. I will be posting a video in the near future on how to get under the horse correctly for tester use.  

There are many types of hoof testers that can be purchased. At our school I recommend a hoof tester with a spring gauge, that allows the student to develop a better feel for its use. 

Spring Gauge Hoof Tester

The key to using hoof testers correctly is to be consistent in the amount of pressure applied over each area you wish to test. Where many texts suggest that hoof testers are used to pinpoint pain, I suggest that you begin to develop a feel for their use. The amplitude of a response can tell much more than simply the location of pain. Response can tell you what structures are involved, to what extent the damage might be, and just how much can you do to alleviate the pain. They will help you to determine if further imaging may be required, or if it is simply a matter of time that is needed to heal the problem. Learn also how to communicate your findings to the attending veterinarian. At our school we note hoof tester response on our Spectrum of Usability.
On this form we note response on a scale of 0 to 3, with "0" being normal. When the response is very slight it is noted as 1/3, when it is moderate 2/3, and when it is severe 3/3. The rating scale is used for rating digital pulse as well. I also mark the location of the response on the illustrations at the bottom of the form. I recently attended a farrier and veterinarian conference in France where a farrier was presenting a lecture on the Spectrum of Usability and the first slide on his power point was this image. It is good to know that other farriers are recognizing the need for documentation to help in our communication with the veterinarian.

Here is how you can develop your hoof tester skills.

Suggested Exercise

First it is important that we establish a base line of response. Going directly to the foot we believe is causing the lameness may solicit a response, but this does not tell us the severity of the problem. Like a lie detector test, we must first establish a line of questioning to determine the level of comfort for this given horse. Some horses are very sensitive to the pin-point pressure of hoof testers, but move soundly on the line or under saddle. Where others give no response to testers, yet expel an abscess in the next 48 hours, you never know. I find it best to try and eliminate the variables in most everything I do, and with the use of hoof testers is no different. 

The procedure of being selective as to which hoof to begin helps in determining if a compensatory lameness exist, along with what first appears to be the primary lameness in the foot. I will note how the horse offers up each limb, and how it reacts to my manipulations, as compensatory lameness may manifest itself in muscle or joint and certain movements can trigger an unexpected response.

Starting on the hoof that is farthest from the limb suspected of causing the lameness, I use the following procedure. Example: If the right front is suspect I begin on the right hind, as the left hind (diagonal lameness) is most common in compensatory lameness. I then go to the left fore (bi-lateral lameness would be the second most common), then to the left hind and finally I go to the right fore the suspected foot.

Begin using your hoof tester to test the sensitivity about the distal border of P3. Applying mild pressure at 1 o’clock, 12 o’clock, and 11, o’clock. Stay consistent with the amount of pressure applied to each point. Next, apply pressure diagonally to the fog as pictured below.  This move places pressure on the Navicular apparatus. You may also elect to apply pressure diagonally to each bar, and to the seat of the corn in the same fashion. In all the described moves attempt to keep the outside jaw of the tester (the one applied to the hoof wall) as low as possible on the hoof wall. If you solicit a response to any of these points, make a mental note and continue your hoof tester evaluation. When finished I make record my findings on the Spectrum form. I do not offer a response to the handler or owner while under the horse. Often a horse will appear to be offering a response to the handler or owner only to have the response solicited by a fly or protest to your manipulation. You should wait until you have completed your evaluation before offering any comments.

Practice this procedure often. I recommend that a base line of reading be taken on all first time visits. It helps in determining the current state of health.

A note of caution, never apply excessive pressure with testers. You are not trying to cause pain, you are trying to determine if there is pain. The spring gauge hoof tester applies between 50 -75 pounds of pin point pressure when brought to the first line. I recommend that you start there and develop a feel for the tool. Experience will help you determine how to best use the tool.