Why Digital Pulse?

Why take Digital Pulses? by KC La Pierre

What is the Digital Pulse? Digital in this instance denotes the digit or foot and pulse refers to the pumping of blood through an artery or vein entering or exiting the foot. To be more precise, the digital pulse is taken or referenced at what is called the V.A.N. apparatus. V.A.N. stands for Vein, Artery, and Nerve. V.A.N. describes the physical conformation of the vascular structures located in a specific location on the pastern of the horse.

If you were to place your fingers on the front of the pastern, mid way between the coronary band and the fetlock (ankle), and slowly slide them towards the inside of the pastern, your fingers would slip into a slight hollow. This is the location where you would take the digital pulse.
The digital pulse is a reliable indicator of what is occurring within the vasculature of internal foot, including whether inflammation may be present within the confines of the hoof capsule.
In the normal horse at rest, locating a pulse at the V.A.N apparatus can often be difficult, as it is very faint, this because systolic pressure (arterial blood pressure created by the pumping of the heart) is relatively low in this location. With increased exercise and the accompanying increase in blood pressure, the pulse is more easily felt. This is why you should check digital pulse (DP) before exercise. You are not attempting to identify pulse "rate" but rather "pressure."
The vasculature of the equine foot is unique in several ways: Firstly, the veins within the foot do not have valves in them. Valves within veins prevent back flow of blood through the vein. Secondly, there are no A.V.A.'s (Arterial Vascular Anatomsis) described as  bypasses that allow for blood to be shunted from an artery directly to a vein, bypassing the delicate capillaries. Lacking these features, the vasculature of the foot, lying between the internal foot and the hoof capsule is  readily influenced by changes in circulation.
Changes in circulation can be the result of an increase in blood flow, or by a restriction of flow within the vascular caused by inflammation. It is very important that you determine which of the two may be occurring.
Both cause an increase in pulse at the V.A.N. apparatus. Increased blood flow in most cases is a good thing, whereas inflammation resulting in the inability of the blood to enter the foot correctly is a bad thing. Restriction due to inflammation can result in blood being shunted by A.V.A.'s that are present in the vascular at the coronary band and above. With blood being shunted from the arteries to the veins before it enters the foot,  pressure felt at the V.A.N. is  increased.
It is safe to say that lameness usually accompanies inflammation in the foot. Also, heat will be felt when you rest your hand on the outer hoof wall. If you have an increase in pressure, but there is no heat, or lameness, it is likely that the increase in pressure is related to an increase in blood flow. You should be aware that there is a fine line between increased circulation and inflammation. The cause of vascular dilation and increased circulation can also result in inflammation.
My advice is that you learn how to take your horse Digital Pulse and take the time to observe the pulse each morning before you exercise your horse. Do this for at least a week. I rate DP on a scale of 0/3 with 0 being normal. If I have difficulty finding the pulse it rates a 0. If it is faint it is rated 1, if it is easily felt it rates a 2, and if it is bounding I rate it a 3. You should be checking the pulse when your horse is sound to establish a baseline. If after a week you have found it normal for your horse to have a faint pulse, then faint pulse for your horse would rate 0. This will allow for early detection of changes in the foot's circulation of "your" horse.
Here is how you use your baseline.

0   Normal, no concerns
1   Monitor daily for change, no real change in daily routine.  
2   Horse should not be exercised, and veterinarian should be consulted.    
3   Treat as an emergency; horse should be seen by your attending veterinarian at the earliest possible time.  

I do not always treat immediately for inflammation when I have a 2 or even 3. I first want to determine whether there might be an abscess brewing. Treating for inflammation will hinder the abscess process. Abscesses often have to run their course and anti-inflammatory can stop the process leading to complications down the road. If you are not sure, it is always best to consult your veterinarian.

About the Author: 

Keith "KC" La Pierre APF, RJF, CF, MIAEP has been a farrier for more than 30 years. KC is the co-founder of the Institute of Applied Equine Podiatry. KC teaches and lectures on Applied Equine Podiatry through out the world. KC has developed and introduced dozens of innovative theories, methods, and products that continue to improve the quality of life of the horse. 

When does a trade give birth to a profession?

We don’t need another new shoe; we need a whole new Profession. by KC La Pierre, MIAEP

One Professional's Point of View

There’s no question about it, research on the horse’s foot is booming. Concerns over foot related injuries and lameness associated with the lower limb have become insurmountable. Educated horse owners, breeders and trainers are looking to the professional hoof care provider for answers. Though all to often the concerned horse owner and professional  have become disenchanted by the redundancy of the antiquated approaches and treatment recommendations offered them.  With so many equine research projects underway you would have thought that answers to hoof care related problems would abound.

In this decade research into the complex genetic and environmental interplay that shapes the equine foot and determines its demise is an area that has moved to center stage at many universities. Who will this new found knowledge be communicated to and will those in the field have the skills necessary to make use of this information? The real question is: will the minds that breathe life into the struggling farrier trade come from the hallowed halls of the veterinary universities, or will this rescue come from those educated at the traditional farrier’s school?  These were a few of the questions pondered while revising curriculums of study at the Institute of Applied Equine Podiatry. In order to accomplish our goals of providing the most relevant and progressive education possible we also decided to take a good close look at the educational systems that were being offered those wishing to enter the field of farriery.

Most farriers schools attract and accommodate those students that wish to enter a trade, those
hoping to be able to make a better than average income and to do so while having to meet only limited academic requirements. As an example: In the UK, the farrier student must attend one of the nation’s approved farrier colleges, the actual semesters for academic study at these colleges is eight weeks the first year, six for the second, four for the third, and two weeks in the fourth and final year. The remainder of the student’s education is spent in apprenticeship with an approved mentor, the master farrier. It is likely that it has only been in the two decades that you would find a teacher (master farrier) that would have attended college themselves. The reason; it was in the mid 70’s when the registries began and at that time most all working farriers fell under a grandfather clause and did not have to attend college. In many cases these same farriers would take an apprentice under this new system. Though this system may have been flawed, it remains far superior to any other form of farrier educational system in the world today and has undergone substantial change over the past five years. In the United States however there is no regulation of the farrier trade. Formal education is strictly voluntary and as a result quality varies greatly. Don’t get me wrong, I am not saying that education in the farrier trade does not exist, on the contrary, it exist alright, but we need to accept the fact that growth within the farrier trade is nearly nonexistent, and that we need to find a way to revive a somewhat antiquated and all to often inadequate trade.

I believe that if we are to see rapid advances in the understanding and treatment of the equine foot, we need to promote a profession that will attract those minds that will accelerate the science of hoof care. We need minds that will take equine podiatry and the farrier trade out of the Victorian era.

It is my belief that the practices and principles of Applied Equine Podiatry hold promise in better understanding the equine foot and that the practice of Applied Equine Podiatry is in fact defining a new equine related profession. Applied Equine Podiatry is a profession that continues to attract the minds needed to advance the farrier trade. It has been said that Applied Equine Podiatry is actually an evolution of the farrier trade.

Let me share this bit of proof with you. Attendance to the Institute’s five day courses on the science of Applied Equine Podiatry has grown steadily over the past decade. Enrollment in the Institute’s full time diploma program has shown a dramatic increase in the past three years, so much so that it dictates our company’s expansion.

Of interest are the demographics of the students interested in hoof care or AEP as a
career. The demographics of the Institute’s students may be a good indication of where hoof care needs to go, and where it is going. Our students range in average age from 24 to 54 and most have a high level of formal education, many holding advance degrees. What is the reason for this? What attracts this type of person to a profession that in many eyes is reserved for those having a stronger propensity toward the physical attributes? I think the answer is; a common desire to improve the quality of life of today’s horse.

Many students come to us because they are disappointed in what their farrier and/or veterinarian have had to offer. Some felt a strong desire to move toward that which appeared more natural. Why they come to AEP is important, but not as important as their thirst for knowledge, it is this thirst that is the fuel that will advance Applied Equine Podiatry as a profession.

In my humble opinion, Applied Equine Podiatry as a profession has over the past 15 years proven itself to be a viable alternative to the traditional farrier trade.

For more information about Applied Equine Podiatry visit our website at www.equinepodiatry.com 

Not Just Another Trim.

The HPT Method, not just another trim!

Copyright KC La Pierre © 2001

The HPT Method was developed in direct response to the Suspension Theory of Hoof Dynamics (La Pierre, 99). It is the author’s belief that this theory closest represents the true bio mechanics of the hoof. As the theory was forming, it became increasingly apparent that how the hoof dissipated the energies created during impact played an important role in keeping the horse sound, as did the utilization of the energies created to execute the stride. As with any object subject to kinetic energy, its shape is what determines where the energies are directed, thus hoof conformation and how a trim was applied appeared to be of greatest importance.
That said I find it important that I respond to a statement that has been presented recently more than once. The statement simply put; “The HPT is just the same as any other traditional trim, just applied well and that’s why the horses on it are going sound.” This statement has been echoed on many of the farrier and barefoot chat rooms from farriers all over the globe, including a select few from the UK and Sweden.
First, I will say that the HPT does not resemble the traditional wall bearing trim, but that is not what makes the HPT unique. What does make the HPT unique is the Method, the term HPT should not be used without its association with the term, Method. The HPT Method in itself is a tool we use to achieve proper structure in the hoof while practicing Applied Equine Podiatry.
For centuries, the farrier student has been taught how to apply the traditional trim to the horse. The method of teaching a traditional trim varies greatly among teachers and schools. This has led to an inherent problem; having a multitude of difficult to define reference points being left to the interpretation of the student. Applying a trim cannot be compared to mechanics or mathematics, it is not simply completing the formula or outlined task, and there are few true absolutes. Applying a correct traditional trim depends on one’s ability to correctly reference a multitude of factors that we have been taught were important to achieving balance in the hoof. None of these can be defined as absolutes, but have been misinterpreted as such. Angle of hoof is one such absolute that has been badly misinterpreted. In an effort to justify that which the student has interpreted, they are led to believe various measuring devices have been used to confirm what is being perceived as an absolute.
Thus, absolutes are perceived by the person reading the protractor, dividers, tee squares and rulers. It is impossible to state an absolute such as hoof angle and then expect anyone to use a device that uses undefined reference points to achieve the same. The protractor and dividers for instance, use reference points that are vague; therefore, any absolute perceived is based solely on the user’s interpretation of these points. Example: dividers use the hair line and protractors use dorsal wall and sole surface, all of which can be deviated to the point that the only absolute that can be stated is that neither can be measured accurately with these traditional tools. Further, traditionally we are taught to use external angles to guide us in applying a trim. Such angles involve shoulder to pastern angle in relationship to the hoofs’ dorsal wall angle. Is this an absolute? What about dorsal wall angle to heel angle and hairline to ground as so on and so on and so on?
It is true that with years of practice and experimentation, the farrier can capably apply a correct trim. This is a statement often used in defense of the traditional farrier sciences. “Leave it to the experts; it takes a long time to learn what is needed to trim a hoof properly or to treat hoof lameness.” There are some farriers out there that have the ability to interpret or read a hoof and apply a proper trim. Most of these farriers have taken many years to get to the point where they can make this claim and the percentage to those that can not is overwhelming, in my opinion. What of the thousands of horses being used to gain this expertise?
Just as we have seen a misinterpretation of the many natural trims being practiced, how the traditional trim is applied has been misinterpreted to a far greater extent. By having so many variables being left to one’s individual interpretation, it is little wonder there has been such difficulty in defining the proper trim. Therefore the true definition of a proper trim should be defined by the results obtained – a sound horse.
The inherent problem is that the traditional farrier science does not provide a solid method for teaching the application of the traditional trim and further, does not scientifically support its efficiency in its aid to the shoeing process. Yes, there are outlines on how to trim a hoof; many are mostly based on ones ability to visualize what lies beneath, (bone structure) and what is proper for balance. Dr. Doug Butler, author of “The Principle of Horse Shoeing III,” and renowned educator, stated recently 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 the method for doing a traditional trim is based on one’s ability to interpret so many variables and the experts are finding it difficult, then my belief that there is an inherent problem has been confirmed.
The HPT Method, though not developed to answer the above outlined problem, does to a great extent do just that. As stated earlier, the HPT Method was developed as a result of my beliefs on how the hoof deals with force. The trim is applied using far fewer reference points and those being used, easily define balance as outlined by the traditional farrier sciences. It further answers a more important need; the need for a method that can be taught to a student and allow that student to obtain a proper trim. Proper trim defined by the results – a sound horse.
If the farrier sciences and their advocates were to continue their assault on the natural hoof care movement and the many trims being practiced, it would be advisable that they first define the methods used in teaching the traditional trim and aim at educating the professional at large.
The true issue here is not whether a horse can go barefoot or not, it is whether or not a horse is sound for its intended use. If a horse is shod and is lame, it may well be the trim. Does this mean the horse should go without shoes? This depends on hoof conformation and whether or not the HPT can be applied to improve the overall conformation of the hoof.
It is my belief that the hoof conformation cannot be corrected with the application of a shoe and that the remaining structure and its provided environment is the determining factors in whether or not the hoof can be corrected. Can a hoof be deviated so badly that it cannot be corrected? To say no would be irresponsible of me. There are hooves that have been deformed either by man or by accident that cannot be corrected by just a trim. You will notice that I did not say by nature. God provides, man interferes, and accidents happen. Someone recently asked me for percentages, not numbers and that is fair. I have found that 7 out of 10 horses that had owners interested in having their horses go shoeless were capable of doing so. Also, I have found that 8 out of 10 horses that came to us for treatment for lameness have shown marked improvement over their being shod with therapeutic shoes. Were all the shoes applied incorrectly? By what and who’s standard? It was more important that I determine whether or not the hoof conformation was a cause for lameness, and then decide on how best to improve the situation. Simply stated; the HPT Metho is a means by which a person can learn to apply a proper trim that has shown promise in the treatment of lameness associated with poor hoof conformation, as well as proving to be a trim for the high performance horse in many cases. Is the HPT just a traditional trim being applied well?
The answer is no, the HPT is a method being used to apply a proper trim in order to promote proper structure:Applied Equine Podiatry

About the Author:

KC La Pierre, a horsemen for over three decades, a graduate of Brewer School of Harness Racing and holder of a USTA trainers license in the early 80’s. He became a professional farrier after becoming dissatisfied with the work being performed on his own horses.
KC has been a professional farrier for nearly 33 years, certified with the AFA since 1989, passing their Journeymen written exam in 1990 and a Journey member of the Guild of Professional Farriers. After working 11 years at doing it traditionally, KC felt something was missing. He began to think that by increasing his forging skills he would be able to produce therapeutic and finely crafted hand made shoes to help in his rehabilitation of the deformed hoof and the lame horse. To this end, in 1994 he began an apprenticeship as a Traditional Blacksmith at the Farmers Museum in Cooperstown, NY under the guidance of Master Blacksmith Paul Spaulding. Two years later, armed with his improved forging skills, KC began applying hand made shoes of all types, only to come to the conclusion; the shoe was not the answer.
It turned out to be the teachings of the Master Smith, KC had learned to break things down to the simplest denominator and determine how things worked before forging them. It was this mindset that allowed KC to look closely at the hoof and determine that the answers were to be found on the inside. The results; Equine Podiatry based on The Suspension Theory of Hoof Dynamics and the HPT Method. KC is the Co-Founder of the Institute of Applied Equine Podiatry, Inc., which provides horse owners, vets, and farriers hands-on workshops to learn Applied Equine Podiatry as well as a three level certification program for becoming a DAEP. KC now teaches throughout the United States and abroad. His environmental research includes the wild horses of Abaco, Bahamas and many others.

IAEP, Inc.
KC La Pierre
www.equinepodiatry.com

Evidence Based Farriery

Evidenced Based Farriery? by KC La Pierre, MIAEP, MAEP, APF, RJF, CF

Over the past month, graduates and students of our school, The Institute of Applied Equine Podiatry, have sent inquires voicing concerns over an article that was published in The Horse magazine. The article;" Evidence-Based Farriery: The Proof is in the Hoof" By Erica Larson, News Editor Apr 15, 2015. This article voices the opinions of several veterinarians concerning their take on the practice of evidenced based farriery. The question posed by our graduates; Don't they know that Applied Equine Podiatry is based entirely on evidence based farriery? comes up frequently.   Each time I would read such an email I found myself holding back a smile.
Why don't they know what we teach? The answer to that question is actually quite simple. Within the conventional veterinary/farrier industry, our work has always been lumped in with the barefoot movement. Why? Because our studies and teaching focus on foot structure, function and performance with little emphasis placed on the application of horseshoes. This is true of our entry level program. In our advanced level program, horseshoeing and digital orthopedics is an integral part of learning.
With that being said, it never ceases to amaze how acknowledgments can be found in the strangest of places. After nearly 15 years of teaching foot bio-mechanics and dynamics with little interest shown by the conventional veterinary sector, it was refreshing to see a leading Equine Podiatrist Stephen O’Grady, DVM, MRCVS state in the above mentioned article, “You can take biomechanical principles and establish the center of rotation in a horse’s foot. You can trim the horse’s foot according to biomechanical principles, and that way you can put some standardization into each trim. That’s evidence-based because … we have the support saying that biomechanical forces can be applied to the horse’s foot and therefore used as guidelines in trimming.”

Note: The use of the Dynamic Balance Hoof Level is supported by O'Grady's above statement. We have taught that standardization (consistency) can be achieved by balancing to the center of rotation on all planes, simply stated; balancing of hoof capsule to the foot within , while the the biomechanical forces applied to the horse's foot should be viewed as the stimulus for the development of structure.

Essentially, all of what O'Grady proposes is being taught at the Institute and has been for nearly 15 years. In fact, the very cornerstone of our teaching underpins the definition; Structure + Function = Performance.
Our curriculum includes an in-depth study of the structures of the equine foot and their functions, and physiological sequencing.  In 2000, we began teaching the Suspension Theory of Hoof Dynamics, a theory grounded in evidence based farriery, Bio-mechanics and Energetics within the foot are all addressed. Several of the papers referenced in the article in The Horse were used in support of the development of this foot function theory, along with hundreds of other credible papers. New research is evaluated from a perspective of evolution.
Also in the same article was written, O’Grady believes researchers need to focus on “evaluating the horse’s foot, evaluating the structures in the foot, the appropriate trim, and finding your way about the foot.”
In 2001 we introduced the use of the Spectrum of Usability, a tool that is used to asses the health of the structures of the equine foot. In 2014 at the Veterinary Conference in Poa, France, a well-known farrier presented the Spectrum of Usability proposing it be used by farriers and researchers alike.

Here is just one of the many power points we utilize in teaching the use of the Spectrum of Usability; Assessing Structures

Our program has been completed by veterinarians, farriers, and students entering into a new career. We are encouraged by the fact that we have graduates in over 15 countries, all of whom practice the principles of Applied Equine Podiatry. With over 15 years of scrutinizing and continued re-evaluation of curriculum content, we can say with confidence that the fundamentals taught at the Institute are grounded in evidenced based farriery, even though we don't teach forging. Thank you Stephen O’Grady, DVM, MRCVS for offering up your definition of what constitutes Evidence Based Farriery. It is refreshing to see that lateral thinking has a unique way of infiltrating even the most vertical schools of thought.