Fall Applied Equine Podiatry Course

Today is the first day of the fall AEP course being held in Ocala, Florida. It is always encouraging to meet horseowner, farriers, and veterinarians that are seeking knowledge and that are open minded to new ideas. I am excited to be including information and education on achieving dynamic balance. This will be the first course in the U.S.A. in which I will be using the newly released "Dynamic Balance Hoof Level". More on the level to come. It' going to be a great course.

Trim, Trim, oops, Trim

I've been saying it for over a decade; our profession does not offer up a solid model for learning how to apply, with consistency a balanced trim. Recent studies suggest that today's farriers may start out  handicapped, in that they are not provided the tools needed to quickly develop the skills needed to consistently apply a correct trim. This is not my finding, evidenced based research supports these statements. The fact; regardless of how skilled one is at forging and shoeing if the shoe is applied to an imbalanced foot the results are going to be less than desired.
So what is the answer? One of my pet peeves is when someone constantly comes up with a multitude of problems, and then wallows in the woe of the seemingly unsolvable, never offering positive input. I for one believe that there are solutions to most all problems, so long as we approach the problem from as many perspectives as are available. Before we can do that we first need to state the problem in as many ways as we can. Wait a minute, didn't I just say that was a pet peeve of mine? No, I said those that wallow in the seemingly unsolvable was my pet peeve.
The problem: Difficulty in applying balance to the hoof. The lack of consistency in applying a balanced trim. Difficulty in teaching the application of a balanced trim. Lack of a solid model for teaching a balanced trim. Difficulty in defining a balanced trim. Lack of tools available to aid in achieving a balanced trim. I am sure that you could add to this list of problems and for each you may be chomping at the bit to offer a solution, but before you start pounding at those keys to submit your comment let me offer up one more problem.Contemplate this problem; how to implement the solution.
You don't believe there is a problem? Well you may be among the minority in the farrier industry. Dr. Doug Butler, author of “The Principle of Horse Shoeing II,” and renowned educator, once stated in the American Farriers Journal that most farriers have difficulty visualizing the internal bone structures and their relationship to the hoof capsule.  I find this remark to be of paramount importance. If a trim is based on one’s ability to visualize and the experts are finding it difficult to do just that, then my belief that a problem exist that handicaps our prospective farriers from the start is justified. I invite your comments.

My Horse has a What?

You go out to the barn to feed in the morning and your horse doesn't approach you like he usually does, he just stands there off at some distances with his head hanging a bit lower than usual. Then when he begins to move, ouch he is really lame. You note that he is pointing his right front. Panic sets in, you immediately start looking for signs of injury, you find none. You feel for heat in the affected limb and foot, and you find that the hoof feels warm, warmer than the others. If you have experienced an abscess before you may breath a little easier, even feel a sense of relief. But if you have not experienced it you are likely to call your vet in panic mode, with thoughts of laminitis, broken bone, or stone bruise bouncing from one side of your brain to the other. What I am talking about here is the onset of an acute abscess. An abscess that forms quickly and often works its way out of the hoof following a path of least resistance in a relatively short time. Sometimes your veterinarian or farrier will help things along by probing, creating a path of less resistance that allows the abscess to drain. Once a acute abscess has drained the horse usually feels immediate relief.

Being well versed in the hoof, you would think that if my own horse developed a acute abscess that I would have no difficulty identifying it, and aiding in alleviating my horse's discomfort. The wrench in the works here is the descriptor used in that sentence "my own horse". No one knows my horse better than me, at least that is how I usually see things.

I recall several years ago while teaching at our facility in north Florida my wife interrupted my class to say that one of our horses was really lame. As described above, she went to feed and found our big warmblood was not weight bearing on his right hind, he's a big guy over 17 hands tall.

I had adopted him at age 6 from a dressage barn in New York. While in training he was plagued with stifle and hock issues so they retired him to the warmth of Florida. Did you catch that? They retired him because of stifle issues, right hind to be precise. He would often hike his right hind as though he suffered a locking patella. I have always battled with hoof deformity in the right hind, this because of how he moved. Well, we took a break from class and I went out to the yard to examine the big guy. Sure enough he was hiking his right hind. I checked for heat in the limb and hoof finding nothing significant, even probed a little with my hoof knife. Knowing his history and seeing him hike that limb in the same fashion as he has may times, I simply assumed he had injured the stifle. We called our vet out for an x-ray. You guessed it, it was an abscess. You see, even us experts can fall into the trap of vertical thinking, especially where patterns have been established. The vet followed his set pattern of thinking and in this case was correct. I don't regret calling the vet. Though it was tough chocking on such a big piece of humble pie, I can appreciate the lesson learned; Never Assume. I had once again been taught to respect one of the greatest teacher of humility in my life, My Own Horse.

Perhaps I should mention that recently that same horse presented the same scenario, and even though I had been served up a huge helping of humble pie the last time, I still called in the vet. Why? Because I looked at the situation from a lateral perspective, approaching the situation as if it were a client's horse and not my own. The result; it was not an abscess this time. 

Hoof Abscess Video

  

The Ego, Destroyer of Customer Service

As a school whose mission is to produce graduates that place the welfare of the horse above all else, it is only logical that developing communication skills has become a priority. 

I learned a long time ago that customer service did not end when my tools were back in my vehicle. I learned that there is more to it than being on time, or doing a pretty trim or shoe job. If I truly had the welfare of the horse in mind, I needed to learn how to communicate with all involved in the care of that horse, including the owner, and veterinarian. 

Below is a exert from the AFJ blog that illustrates the importance of developing communication skills. I respect the farrier for understanding the importance of listening. "When an owner asks him a question at the barn, He takes his apron off, makes eye contact and listens to what they have to say. He addresses their concerns by answering in a thorough, understandable manner." Communication. Our program promotes the use of a Spectrum of Usability, a form which documents the current state of health of the hooves and horse being worked on. This form keeps the owner engaged and the hoof care provider connected. While it does take time to fill out, it gives the owner time to ask questions. 

For the Applied Equine Podiatrist it is important to develop these communication skills, skills that promote team work. For the Applied Equine Podiatrist a team may include owner, vet, farrier, or a host of other care providers. Customer service is all about communication and team work. When it comes to the welfare of the horses in our care, there is little room for ego. That being said, we all need to be very careful not to mistake confidence and good communication skills for ego. 

From the AFJ Blog: 

El Paso, Texas, farrier Doug Hogue conducts 90% of his work at the clinic of Dr. Paul Jenson in Sunland Park, N.M. Hogue in a conversation with Jeremy McGovern, Executive Editor of the American Farriers journal, explained that he sometimes finds local farriers who are angered because another farrier has temporarily taken over the horse at the clinic. He states; I disagree with the opinion, but I understand why that reaction sometimes occurs. Those farriers react as such when they mistake a farrier carrying out a vet’s script as an unwarranted critique. That’s vanity and pride manifested in unprofessional reactions. Furthermore, it is a missed opportunity to learn and a failure to recognize a deficiency may exist in one’s own work that may have caused or contributed to the problem. Not to mention, what’s more important… the health of the horse or your pride?

A more curious reaction Hogue also told McGovern about is when another farrier is mad because the client didn’t tell him or her that the horse went to the clinic. Obviously this is a case of misdirected anger. And it is a reaction that misses the point entirely. Hogue sums it up best that the other farrier should, “take a step back and realize that there is a problem is in the relationship with that client … they don’t feel there was a need to let that farrier know there was a problem.”

Hogue says the farrier as the cause of this problem is avoidable by staying engaged with the owner. He lets the client know he wants to know as soon as they believe there is an issue with the horse. When an owner asks him a question at the barn, Hogue takes his apron off, makes eye contact and listens to what they have to say. He addresses their concerns by answering in a thorough, understandable manner.

All of this is quality customer service. More importantly, this level of engagement lets the owners know you care about the horse and their business. And it makes finding out about visits to the clinic after the fact a rarity.

What is Applied Equine Podiatry?

What is it about change that is so hard? In my post "Solving Hoof Problems, Laterally?"  I talk about labels and why when something comes along that is different our thought patterns immediately attempt to apply familiar patterns to it. The example I gave was: You have two boxes one is labeled white ping pong balls, the other black ping pong balls. As long as you are handed a white or black ping pong ball you have no difficulty placing it into the appropriate box, you are comfortable, you have established thought patterns that solve the problem. Then you are handed a gray ping pong ball, which box to put it in? Your mind will struggle to choose, though experience may sway you to put it in the black box because you see gray as closer to black, or you may decide that because black is the absence of all color that it needs to be in the white box.  But, what if you chose to break your pattern of thinking, what then? When do you decide that there needs to be a third box?  Hmmm a third box.

Along comes someone calling themselves an Applied Equine Podiatrist, you have two boxes one labeled "Farrier" the other "Barefooter", which box should I put this person into? Like the ping pong ball, you will use an established pattern of thought assigning one of these labels to this person. I'll ask again, what if you choose to break your pattern of thinking?

It is only fair that if I am going to ask you to change your pattern of thinking that I provide you with information about this third choice. So, What is Applied Equine Podiatry?

I get asked that question all the time, at horse expos, lectures and conferences, and in class by the first time student. In class it is a simpler task, offering information that allows a student to practice lateral thinking and thus accept the need for a third box. The question "What is Applied Equine Podiatry?" is an exercise in lateral thinking, and after being challenged hundreds of times by this question I was able to pen a simple definition. I think at the very least the following definition will allow the open minded individual to entertain breaking fixed patterns of thought.

"The essence of Applied Equine Podiatry is the conscientious study of the equine foot, always striving to expose it to proper environmental stimuli, making every effort to promote proper structure and function, as we progress in achieving high performance. It is accepting the fact that the horse has the innate ability to heal itself, and that domestication of the horse has caused imbalance and broken the golden rule of "Do No Harm." 

Over the next few weeks I will post a question or statement taken directly from a past final written exam of our Entry On-Line AEP Program.

The exam is a list of questions and statements that I have been presented with over the past several years. Students are instructed to read each carefully and respond to each as if it were directed to them and as to how Applied Equine Podiatry would or would not apply. Tip: “Whole Health Hoof Care.” The goal of the Applied Equine Podiatrist is to aid the horse owner in achieving a healthy foot.

Here's a question or rather statement presented to our Entry Level AEP students.

  

My horse wears his hind outside heel down much faster than the inside; the shoe prevents the wear and my farrier wedges it to balance him. 

Tip: When a statement is presented, often the answer is a question. 

Perhaps with added insight you to will see the need for a third box. 

Prolapse in the Hoof

One of the very first things taught at our school is the functions of the hoof capsule. We talk in terms of protection, support, suspension, and resistance, the hoof capsule has a multitude functions. One of the most important is to provide resistance to distortions induced by the stride. As an example, the wall of the toe must provide much more resistance to flexing than that of the wall at the heels. The primary reason is the task that it must complete during the stride, function is directly related to a structures foundation. The foundation at the heels is cartilage and at the toe bone.

The wall also helps in protecting the corium (sensitive, vascular tissue) that produces it, protecting against blunt trauma, infiltration of toxins, and prolapse (displacement) of the corium itself.

The most common form of corium prolapse associated with the hoof of the horse is a solar corium prolapse; where by the corium of the sole protrudes from the solar epidermis (horn). This sometimes happens when the horn of the sole is removed to expose an abscess, or following a puncture wound. Other areas of the hoof capsule that have been seen to host a prolapse, though not as common are the frog, and coronary band groove.  

Why does the prolapse occur? As stated above, one function of the hoof capsule is to provide resistance. When this resistance is removed, either by injury or intentionally the risk of prolapse exist. Inflammation and instability are major contributors to the process of prolapse.

How can prolapse be prevented? First and foremost, anytime that corium or living tissue is involved, so to should the vet be involved. As a hoof care provider our work begins and ends with the hoof. Working with an attending veterinarian to prevent infection and reduce inflammation the hoof care provider can help in preventing the prolapse from occurring, by creating resistance where resistance has been compromised.

Resistance does not mean support; it means mild pressure that does not result in pressure necrosis (death of tissue). 

I have attached photos of a case that involved a coronary band prolapse. This type of prolapse is not very common, but can occur when a large area of the coronary groove of the hoof capsule is lost. 

This particular horse suffered an abscess which resulted in substantial loss of resistance at the coronary band. This foot was also very upright, and as a result a higher level of distortion occurred at the sight of the prolapse.

This was treated by providing resistance in the form of a Sole Mate Therapeutic Pad insert. The area was washed with Silvetrasol Hoof and Wound Wash, and the pad was fashioned to mirror the stratum internum (inner wall). 

I then applied a Perfect Hoof Wear Poly Wrap to the foot, paying close attention to the amount of tension applied over the Sole Mate insert. The PHW Poly Wrap provided the resistance needed to prevent further prolapse, while the pad insert provided the stimulus needed for the development of healthy structure. The final picture was taken at four months from the onset of the condition. This package was applied four times. 

Horse Toes?

Throughout history and still today some horses are born with vestigial toes.

Take a look at Alexander the Great’s horse, he was one such animal.  His name was Bucephalus which translates as Oxhead. Some accounts say that he was so named because he had the image of a bull's head on his shoulder. The name conjures up mental images of a warhorse with a massive head and chest, that carried brazen young conqueror. Quite the picture, but did you know that Bucephalus had vestigial toes (extra, non-functioning).

Toes on a horse are an evolutionary legacy akin to human tailbones and gills in womb. Embryos of modern horses develop the rudiments for three toes in utero. Ordinarily, the middle toe will eventually outgrow the outer ones which then become splint bones. This central toe is then the one which will support the horse through contact with the ground, ie the hoof. Bucephalus’was a polydactyl, which means having more than one toe; his toes  did not develop in the normal manner during gestation. 

The legend of Bucephalus’ mutation was nurtured, imbuing the horse and his owner with mythical properties. The toes, in some way, embodied the outstanding nature of his master’s life, as if everything he touched was extraordinary. Centuries later Julius Caesar hung on the coattails of this myth by sourcing a three-toed horse and protesting that it would let none other than the man himself ride it.