Okanagan School of Natural Hoof Care
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Extreme Founder Rehab Case Study

9/12/2022

1 Comment

 
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This Arabian mare came to us in the early summer of 2022 in hopes that we could improve her comfort and hoof health. She has been foundered long term and was suffering from acute and frequent bouts of laminitis when she arrived. She was very overweight and showed the classic signs of being insulin resistant. We immediately changed her diet to low sugar hay only, and we trimmed and applied the Easyshoe Versa Grip Lights with 11 Finger Tabs. I applied these with DIM and Artimud. This is my usual favorite composite shoe package. I will be using these until her new hoof wall grows in and the sole can start developing some concavity. The shoes support the frog and digital cushion while providing protection and "artificial concavity" to the sole. The DIM provides a cushion to absorb impact and also works to keep debris from getting in-between shoe and the hoof. A thick layer of Artimud between the DIM and the hoof keep the hoof clean and fungus free.

Throughout her rehab here she has been intermittently sore, but overall shows signs of improvement. We also had her tested for PPID and the results were borderline high, and inconclusive but we chose to treat with Prescend and the results have been great. Her laminitis has subsided and she is growing in connected hoof wall, which was otherwise not possible. She has also lost an incredible amount of weight and actually almost appears too skinny, though I would rather her be a tad bit underweight until her hooves grow in more connected and can better support her.
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September 11 2022 Video Update

September 11 2022 trim/shoeing photos


August 26 2022 Progress Videos


July 1 2022 trim/shoeing photos



July 2021 Radiographs

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Left Front
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Left Front
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Right Front
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Right Front
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Foundered Case Study with PPID and IR Complications

2/16/2022

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This the front right hoof from the medial side

​I had spoken on the phone to the owner of this horse prior to arriving and I was prepared to deal with a foundered horse, but I wasn't aware of the severity.

This horse has been under veterinary care and was seen by the farrier every 4 weeks for the last few months. There are also underlying PPID and IR issues.
This horse has been very lame for the last year. 
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front left hoof
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front right hoof

​The only radiographs I had to work with were from 6 months previous. They show significant sinking and rotation, but I suspect the damage is even worse judging by the current state of the hooves. Current radiographs would be extremely helpful, but in this case they are not available.
While this trim seems fairly drastic, I am sure I could have done more if I had current x-rays. This was a step in the right direction to restore function and set up the new growth for coming in. The owner purchased Easyboot Clouds to keep this horse comfortable moving forward and we plan to trim every 3 weeks to start.

In the pictures above you can see the huge lamellar wedge. There is so much separation in this hoof wall. I also tried not to touch the sole at all, what I did trim on the bottom was the overlaid bars and overgrown frog. I also tried to lower the heels to realign the bottom of the coffin bone. This horse has very thick bone, and will naturally have a slightly longer heel then the average 1.25 inches because of that.

From a metabolic standpoint this horse is on low sugar hay in slow feed nets placed around her paddock to increase movement, I also suggested adding biotin to her diet to help with hoof growth, and rechecking her ACTH levels to make sure her Pergolide dosage for her PPID is effective.

​I will update this case study with more picutres next time I see her.


​March 1 2022 Trim and update

Since the last trim the owner reports that she is moving better, though still sore. She wears the Easyboot Clouds 24/7 right now. This trim I really worked on bringing the heels down a bit more and removing some more of the large wedge from the top. Because the heels were so overgrown the frog was also overgrown, but at the first trim it was very hard and I didn’t want to remove too much. This trim the frogs were very crumbly and I trimmed them down until all the rotten material was gone. I didn’t trim any sole, but I did trim down some overlaid bar off the sole. The bar was also quite crumbly. This is still a huge work in progress and I will see her again in another three weeks and reassess.
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Contracted Tendons, Club foot, Crenas Oh my!

2/6/2022

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I got a lot of interesting comments when I posted this picture on social media the other day. I thought I would take a minute to explain this horse's situation and how I handle it.

This horse has bi-lateral contracted tendons, which means both DDFT's on his front legs are short, and also has a club foot on his front right, and a suspensory injury on that front right. This poor horse just has the deck stacked against him.

Dealing with the contracted tendons is tricky. It's important to perform the "stretch test" to determine his ability to extend the DDFT's before deciding how much to lower his heels. The stretch test is when I extend his leg forward and straighten the the knee, and then fully extend the fetlock and pastern. Through this we can measure the horse's range of motion and comfort level. It's important to do this a couple of times and form an assessment based on multiple attempts. Assuming he has a good range of motion and can extend the leg I can then decide to lower the heels based on his extension capabilities. I also use this stretch to help determine heel height on club hooves.
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Performaing the stretch test, in this case we could straighten the knee and extend the fetlock. The last step is to fully extend the pastern but tipping the toe up toward the sky. I do this very gently, allowing the horse to pull away at any moment if the stretch become too much.

This is just one thought process I use when determining heel height, I also need to assess the hoof itself, including the pastern angle and the frog health, sole depth etc.

From the bottom of the hoof I want the heels to ideally be in line with the collateral groove exits, the frog height and sitting just a little bit above sole level.

This horse grows hardly any toe, and due to the contracted tendons and club foot the dorsal angle of the coffin bone is quite steep. This leads me to suspect possible coffin bone rim edge damage, due to the fact the coffin bone is perpetually on it's tip. He also has a small crena in the sole at the toe further leading me to this conclusion. A crena is a little dip in the sole, caused by a missing piece of coffin bone, which in turn means there is a missing piece of the solar corium that grows the sole. This results in a tiny divot in the sole, usually right where the tip of the coffin bone would be. 
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You can see here the slight divot in the center at the toe immediately behind the golden line. The golden line dips down and in this picture there is a bit of dirt stuck into the recessed golden line.

So what's my plan? Generally speaking he has good flexibility in the leg so I can lower the heels about a 1/4 inch at each trim. This leaves them sitting about a 1/4 inch above the height of the sole. In a perfect world I'd like to trim him every two weeks and lower them and 1/8 of an inch at a time instead. I rarely trim the toe other then applying a bevel from the golden line outward, and I usually have a bit of frog to trim and clean up. Thankfully he grows very nice upright and manageable bar so trimming it is easy. I just ramp it down from the heel following the natural concavity of the hoof.


I usually apply a bevel to the heels anytime I have to leave them higher then I would like to. This can also be called a "rocker". ​
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A "rocker" allows the heel to float just a tiny bit off the ground while the rest of the hoof is weighted.

With a rocker applied, during motion the horse must extend his stride and flex the tendon just a little bit more in order to land heel first. You must be very careful with this that you don't ask them to extend any farther then they can comfortably handle. If you trim your heels too low or apply too much rocker you could cause them to land toe first to alleviate the discomfort, and/or risk injury. My aim to to ask for an 1/8 of an inch, and over time keep bringing that heel down until it is at a normal level. This of course is the plan, but it is sometimes a work in progress throughout the entire lifespan of the horse. 

Adding to this complicated case is the suspensory injury this horse has. He has an old fractured split bone and as the lower branch of the medial suspensory ligament  moves across it becomes torn and jagged. This has lead to an abundance of scar tissue forming, creating less flexibly and range of motion and frequent bouts of lameness as the inflammation flares up. This pertains to my job aligning the hoof as I don't want to further aggravate the injury, so I am forced to trim very conservatively until the owner and vet decide on a course of action for this reoccurring issue.
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Foundered Mini Before and After Trim

8/8/2021

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This 5 year old mini found her way here recently, her history is unknown. She is severely foundered and was having difficulty walking, and spent most of her time laying down. She doesn't appear to have the typical metabolic syndrome "look" to her, I suspect she has foundered from lack of trimming. Although this trim is significant, I will be trimming her again in a week or so to adjust a few more angles, lower some of the heels a bit more and double check the hoof balance. This was a big change for her and she was very sore so I had to work quickly and didn't get a chance to really make the trim complete. After the trim she is moving well, though still a little bit stiffly. She will have 24/7 turnout on the track with the herd, and I suspect the stiffness is more body related due to the angle changes and will subside quickly. 
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Full Length Barefoot Trim VLOG

5/31/2021

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This is a maintenance trim on Jack, our IR school pony. He is trimmed every 4-6 weeks so there is usually little distortion and just a bit of excess length.

Because he is IR, we diligently manage his weight and he rarely if ever gets grazing time (always with a muzzle). He lives out 24/7 on our Paddock Paradise track system.

​Please excuse the sometimes less then perfect video angles, trimming while filming with my GoPro on my head is a bit of an art lol.
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Rehab of a foundered lesson horse - Odin's Case Study

5/28/2021

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April 13 2021

The pics below are from Odin's initial shoe pull and trim. We applied composite shoes to his fronts to provide artificial concavity due to his flat soles. You can see the long leveraging toe, flat sole and low, crushed heels.

I opted to set the breakover far back under the composite shoe in order to reduce the leverage on the new growth just below and coronary band.


​May 18 2021

Today I pulled the composite shoes and after the trim applied Glue on Easyshoe Performance shoes.
The focus was on bringing the toes back to relieve the leverage on the hoof wall as well as to allow the heels to come in at a steeper angle in order to bring the weight bearing surface back underneath the horse.
Read through the comments on the individual pictures for a more in-depth explanation.



​Jan 30 2022

A bit of time has passed since Odin's last update. He recently became one of our school horses so that I can give him the routine care that I think he needs. Odin presents as quite stiff and sore and very reluctant to move forward. I think he has a few combined issues and I hopeful we can help him to improve and maybe one day use him in our Youth Program. Along with his under run heels, Odin has long stretched forward toes and thin soles. He was also diagnosed with kissing spine before he came here. 

​Today I applied EasyShoe Performance NG's with 11 finger tabs, Duplo wedges, DIM for support and Artimud to combat moisture. 

Before Trim Video

After Trim Video


​Below are the modified composites I applied. I favor the EasyShoe Performance NG's and Easyshoe Versa Grip Lights. You can use plastic wedges as well, or even build up a wedge with glue but I prefer the simplicity of the Duplo Wedges. I love how versatile these composite shoes are with the 11 finger tabs. This pics below show the shoes before I welded more tabs on. These shoes have been used a few times and you can see they still have a lot of life left to be used again. This is one of my favorite things about the 11 finger tabs, they can be ground off and new one welded on once they get too thin or lose their shape.
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Montana - Founder Case Study

2/25/2021

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Montana is a paint mare that presented with a disconnected hoof wall, and both rotation and sinking of the coffin bone. She has an extremely flared hoof capsule and a very flat sole with zero concavity. Her owner repots that she is tender when ridden barefoot and "requires shoes or boots" when ridden to keep her sound.


​January 27 2021

​I opted for a conservative trim, steeply beveling the toe to reduce leverage, but leaving excess heel and quarters in order to provide some "false concavity".

On the bottom view you can see the bruising on the sole directly under the coffin bone from the lack of concavity and too much solar pressure. She has boots and pads to keep her comfortable for now and we will likely move to composite shoes for riding season in order to give her some long term comfort and “false concavity” to relieve that solar pressure.
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You can see the huge abscess she blew along the heel bulbs and frog as well. I wouldn’t be surprised if that starts to separate as it grows out.


Feb 24 2021

Her owner reports that she has been moving really well and only required boots for a few days after the last trim and when riding. 

This trim was similar to the previous one in that I steeply beveled the toe to reduce leverage, though this time I did not leave excess heel and quarter height. The heels were starting to fold over and quarter was breaking away. 

You can see the connected hoof wall growth coming down farther from the coronary band as well. Overall I am very pleased with her progress thus far.
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You can see the connected new growth coming down much farther in the Feb 24 picture. The heel is also moving back, shifting the weight bearing surface farther underneath the hoof towards a more correct position. This also alters the angle of the pastern to be more upright and closer to "correct".


​March 26 Trim

I am happy with the progress so far, the hoof wall connection is coming in and Montana has been moving well. The key here is keeping the leverage back so that it doesn't undermine the connection up higher. 


April 15 Trim

This trim was a couple of weeks early but because I was in her area with my students during the 6 day course I thought we would touch up her trim and use her as a case study to teach the students. Montana is still very comfortable and the connection is coming down the hoof wall. Her owner is still using boots for riding and is very pleased with her progress.


May 14 2021

I got a call from Montana's owner that about 3 weeks post trim she came up lame that morning. We suspected abscessing and the owner soaked daily for about a week. Nothing presented but Montana came in and out of soundness during that time. When I arrived I could not see any sign of an abscess, and noticed that she was very tender in all 4 feet and having trouble walking on the gravel driveway. We concluded that possibly due to the recent rainfall (it had been a previously very dry period) and the wet ground perhaps the moisture had softened Montana's thin soles and we opted to apply Easyshoe Versa composite shoes to her fronts. The owner reported about three days later that Montana was very sound and she was able to ride her. 

My goal will still be to grow in healthy wall connection and allow the sole to thicken. We will likely keep using the composite shoes for the summer riding season with the hope that in the fall she will be able to transition back to barefoot and then hopefully next spring not require the use of composite shoes.
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Flash - Navicular Rehab Case Study

2/23/2021

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I purchased Flash in August of 2020 to be one of our school horses used during our trimming courses and because he had been diagnosed with Navicular Syndrome by the previous owner's Vet and I wanted to both help improve his condition and study him.

I am somewhat skeptical of the diagnosis as it was made without radiographs to confirm, and was only based on the Vet's opinion of how he was moving at the time. If you look at his initial photos and hoof conformation I struggle to understand how a diagnosis could have been made solely by assessing his movement with his hooves in that condition.

Either way I am moving forward under the assumption he may have Navicular Syndrome and treating him as I would treat any horse; with proper frequent trims, a good diet and turnout 24/7 on my track with my herd. 

August 25 Initial Set Up Trim 


​The following video is from Aug 25 2020 and was taken immediately before pulling the shoes and trimming.

Though it's not the best video to showcase his movement, you can see that he us kicking forward sand with his front hooves. This is due to toe first landings.


​August 27 2020, 2 days after trim with Easyboot Cloud boots.

He is still pretty stiff through the body, and if landing flat, avoiding using his heels.


​The following pictures are from September 7 2020


​September 7 2020, Easyshoe Performance Glue Ons


​September 7 2021, Easyshoe Performance Glue Ons


​November 20, 2020, Trim and cast with Easyshoe Flex Lights


​February 22, 2021 Trim


​February 22 2021, After trim, barefoot.

This is by far the best I have seen him moving. Still landing flat and with hesitation, but overall significantly improved from before. 


March 25 before and after trim pics

After this trim Flash was sounder then he has been since he arrived. I have also noticed a huge change in his behavior over the last month. He has finally settled into the herd and has started to approach me and ask for attention. Something he was never interested in before. After this trim I even rode him lightly in the arena for a few minutes, this was his first ride since we brought him home, and probably his first ride in over a year. 

I would still like to see him grow in more hoof wall connection as well as stronger digital cushions. As he grows in more wall connection I also expect that his concavity will increase and his soles will thicken, resulting in less bruising. 


April 19 Trim and Composite Application

Flash has been doing well, he has gone from unsound to sound on the track where he lives and sound in the sand arena. Because of his progress we have started riding him and I have found he is tender on rocks and hard surfaces. I wanted to try a composite application to see if we can build more sole thickness and continue to ride him. I glued on Easyshoe Performance Shoes, with a soft sole packing underneath and topped the application off with a thin layer of 3M casting. 

​The following video was from immediately after the composite application
The following video was from later in the evening on the same day of composite application

December 2021 Update

Watching Flash improve has been very emotional. He has gone from a very shut down horse to an in your pocket and really friendly guy. He is a favorite among the youth that I work with and has been sound enough to use in the program since the August 2021. He spend most of the summer in Easyshoe Versa Grip Lights glued on with the 11 finger tab system. This product packed with dental impression material both protected and stimulated the back of his hooves and caused his frog to grow in wider and thicker, as a result of the improving health of the digital cushion. 

Even though I was watching his soundness and comfort improve I was feeling a bit discouraged with the progress of his hooves until I put these pictures from the beginning of his journey along side the current hoof pictures. I can see that the overall angle of the hooves has changed dramatically and the heel is much farther back underneath the hoof. Also the entire back of the hoof has changed. The frog is wider, but the heel bulbs are also wider and more "full", with a much stronger digital cushion under there. 

While there is still improvement to be made I am much happier with Flash's progress having looked at how far he's come. 
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Dixie - Rehab of a serious hoof crack

1/26/2021

2 Comments

 
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Dixie is an 11 year QH mare, who has suffered with this toe crack for several years. Her current owner purchased her in the spring of 2000 and had been working with a vet and corrective farrier for 8 months without significant progress. She decided to try a different approach and brought her here to OKSNHC for rehab in January 2021.

The album below shows the before photos and first trim results. There are captions on some photos to explain important points.
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January 23 2021


​I will update this blog as we progress. Currently I have applied a trim, and opted to cast her hooves and nail on composite shoes over the casts. I chose this approach to give her stability in the hoof capsule via the casting and to create "artificial concavity" with the composite shoe (Easyshoe Flex Light) to help unload the coffin bone from ground pressure due to a lack of hoof wall connection and a sunken coffin bone.
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February 8 2021 

My plan this trim was to further reduce the long toe and just see how the new growth is coming in. It has only been a couple of weeks since the last trim so not a ton of new growth, but overall I am happy with the progress. Today I opted to cast only and when these wear off in 1-2 weeks I will soak again to treat that crack for fungus and bacteria and likely apply casting and composite shoes again, though she seemed just as comfortable in the casting alone without the composites. 
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March 2 2021

This was the first trim that I was able to lower the heels and quarters to a normal level as I planned to apply composite shoes to create the "artificial concavity" that I have been achieving by leaving them high. Her sole is still very flat, though there is concavity starting to form. The crack on the FR is also starting to grow down from the coronary band closed. This is extremely exciting as this mare has had this crack for 5 years! Overall, there is about an 3/4 of an inch of tighter new growth at the coronary band since I began to trim her on  January 23 2021. I applied composite shoes, packed with Artimud, and plan to leave them on until early April. She was off at the trot before the trim and slightly worse after after. I believe this is due both the shorter trim to accommodate the composites, and to corium inflammation due to the flat sole.  In a few days I will take more video to see if  the inflammation has subsided with the composites applied.

Mar 2 before trim

Mar 2 after trim and composites applied

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A comparison from Jan 23 (top) to Mar 2 (bottom).


​Mar 5 2021


​April 9 2021 Video Update


​April 13 2021 Trim

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April 28 Trim and Composite Application

Overall Dixie has been doing well, but I felt like there was too much pressure on the crack, causing it to continue up into the new growth, just superficially, I trimmed her toe back and for the first time was able to remove the excess heel and quarter that I had been leaving to give her artificial concavity. I applied a glue on Easyshoe Performance, and wrapped in 1/2 a roll of 3M casting to further secure the glue. I also packed the Easyshoe with a soft sole packing. She is moving very sound in this set up. You can see on the glue application that I set the shoe right back to where I wanted her breakover to be. This is extremely important in reducing the leverage on the toe crack. If the shoe is set too far forward as seen in the picture above, the leverage on the crack would be increased causing it to continue to split. 


​June 15 2021

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​August 9 2021 The end of Dixie's Rehab!

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Jan 23 2021
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Aug 9 2021

It's  a bittersweet moment for us here at OKSNHC as Dixie gets ready to go home! Just over 6 months have passed, and Dixie has grown in almost an entirely new hoof! The crack is almost grown out, likely just one more trim will see that through. Dixie's home is about 2.5 hours from me, so one of my students will now be taking over her care along side her owner.

The small vertical crack you can see just above the trimmed area is superficial and will also grow out within the next couple of trims. Over the next 6 months, with proper trimming I expect Dixie to be able to grow in an even better connected hoof wall. You can see the marker lines I drew in the after trim pic showing the various levels of wall angle deviation. These angles are based on hoof leverage and reducing this leverage was my entire goal during this rehab resulting in being bale to grow out the crack.

For over 5 years Dixie suffered with that crack, being worked on by some very experienced and knowledgeable farriers. Clearly from the before picture you can see that they tried everything they knew. Shoes to hold the crack together, glue to help keep it together... I have always and will always maintain, it's not a shod vs barefoot debate, its the trim under the shoe or without the shoe that counts.

Throughout the rehab Dixie had highs and lows. There were some moments she required a composite shoe or hoof cast to be comfortable, and now 6 months later she is sound barefoot. Her transition is not entirely complete, she will require hoof boots for trail riding on rocky ground until she can build more callous and get used to the terrain, but in the paddock, pasture and arena she is 100% sound barefoot. 

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2 Comments

Cinderella story, video update on Ruby the rescue pony

7/16/2018

3 Comments

 
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The photo above shows Ruby when she arrived in late March, the video below was shot July 15, 2018.
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    Kristi Luehr is a barefoot trimmer/farrier, author, and founder of the Okanagan School of Natural Hoof Care. She is certified by the Canadian Farrier School as well as the Oregon School of Natural Hoof Care, and also has certification in equine massage and dentistry. Her focus is to educate owners about hoof anatomy, function and proper barefoot trimming that supports and grows healthy and functional hooves specific to each horse's individual needs. She is the author of two online courses specific to hoof care and is always striving to create more educational content for students to learn from. 

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