Re: Updated Case History with New ACTH/Insulin Levels

Lavinia Fiscaletti

Hi Jamie,

The video shows a typical shoeing trim for a laminitic horse. The dorsal wall gets rasped away to make it more in line visually with the angle of the new growth, but the actual point of breakover at ground level was barely changed. That means the lever forces working on the lamina haven't changed. You don't want the front of the foot leveraging upward on the connections, nor pressuring the tip of the coffin bone that way. After mentioning that the sole is thin and should not be trimmed, he makes a shoe and trims the sole before attaching the shoe. Adding a shoe, then leaving it on for 8 weeks, put the pony right back to where it had been before the farrier did any work. 6-8 week trim cycles are too long to be able to keep laminitic feet in good mechanical condition as they outgrow the trim during that time - which the farrier noted.

You are correct that there is no wall at ground level in the toe on Walker, which is a positive. The sole at the toe is also stretched forward and needs to be taken back so the breakover point moves closer toward the tip of the frog. The lamina you see exposed are part of the laminar wedge, which wouldn't be there at all if the toe was brought back far enough, then maintained there. He shouldn't have hoof wall beyond sole plane level as his wall connections are damaged so not capable of load bearing. The walls are only designed to carry 10-15% of the load when they are healthy. If not healthy, they should be passive until the damage has grown out. It's the sole, bars and frog that are designed to carry the bulk of the load, with assistance from the walls. Shoeing flips that completely around by exclusively loading the walls, while leaving the soles/bars/frogs hanging in space. If pads and proper packing are added under a shoe, that will provide support across the entire bottom of the foot but the tradeoff is that constant pressure is now applied, rather than the pressure-and-release pattern that the structures thrive on.

Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR

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