Okanagan School of Natural Hoof Care
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Extreme Founder Rehab Case Study

9/12/2022

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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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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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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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Foundered Cadaver VLOG

3/22/2021

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This hoof belonged to Ruby, one of our rescue ponies. She was chronically foundered and suffered from untreated PPID before we got her. We tried for three years to help her but ultimately when the bad days started to outnumber the good ones we had to end her suffering.

When Ruby first arrived she was emaciated and had very long overgrown, foundered hooves. But she was the kind of pony who always looked at you with appreciation in her eyes. We had her examined by our Vet right away and he floated her teeth, ran bloodwork and got her started on medication for the PPID. During the next three years she was off an on again sound, and had frequent bouts of laminitis. 
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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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Hoof Growth Rings, Hoof Wall Connection and the Link to Laminitis and Founder

12/9/2020

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In this post I want to address the common myth that growth rings indicate instances of laminitis. While they can indicate laminitis, it is rare that they do, and more importantly they are a roadmap to understanding the connection of the hoof wall to the coffin bone via the lamina.

I have been a barefoot trimmer for 11 years and have been teaching horse owners to trim their own horses for 6 years. Throughout my career I have seen both laminitic and foundered horses and I have been able to successfully rehabilitate many of them. The most important part of the rehab process is understanding the condition that you are dealing with.

Horse owners, vets, and farriers often use the terms laminitis and founder interchangeably, but it is my personal mission to educate people on the correct use of these terms. This is important because the physiology of each condition are quite different. ​​
Laminitis = inflammation / pathology of the lamina.

Founder = Separation of the coffin bone from the hoof wall (detachment of the lamina).
Laminitis alone does not create an external physical change to the appearance of the hoof. Laminitis is inflammation within the lamina of the hoof capsule. It is extremely painful for the horse, and can cause heat in the hoof and a throbbing digital pulse, but it doesn't not create flare externally on the hoof capsule. Laminitis and founder are not mutually exclusive; a horse can have laminitis and not founder, and a horse can be "mechanically foundered" and not have laminitis. A horse can also have laminitis that subsequently leads to founder, but this can often be prevented. For more on this check out our new online course linked below.

Founder is a disconnection between the hoof wall and the coffin bone that leads to the formation of a lamellar wedge (stretched white line). It is a breakdown of the lamellar attachment that allows the hoof wall to migrate out and away from the coffin bone. This results in the coffin bone's tip rotating downwards towards the sole and produces the flare that you see visually on the outside of the hoof.

​When looking at the growth rings of the hoof or at the wall structure itself it is important to know that in a healthy hoof the growth from the coronary band to the ground should be at a uniform angle as seen in the top hoof on the graphic below.
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The hoof on the bottom of the graphic shows the wall coming in at a steeper angle at the top of the hoof and then progressively flaring as it grows down. The flaring indicates hoof wall disconnection and possibly founder. This graphic is from our newly released Laminitis and Founder Online Course. Check it out for more info on the complete rehab process and further clarification between laminitis and founder.

​In the picture below you can see significant growth rings present both halfway down the hoof and also just below the coronary band. This was a picture sent to me by a student who was worried her horse had suffered laminitis and she had not noticed it. The horse had not been lame or sore but because of the growth rings she was worried that she wasn't on the right track with her trimming. I get asked this question a lot so I though it best to explore it in this post. 
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This horse was foundered when the student started trimming it a few months ago. I can tell this by the flared and rasped lamellar wedge in the bottom third of the hoof in comparison to the new growth angle at the top. With proper trimming resulting in a reduction of leverage on the lamellar wedge, the hoof wall and coffin bone that were once separated are reattaching. As they do so they are creating a tighter connection that when it grows down from the coronary band appears as a tighter growth ring. The first significant change is shown at the ring halfway down the hoof wall. This is when the correct trimming started that allowed the hoof wall connection to resume. The second ring just below the coronary band shows where the connection became even tighter as more of the wedge has been grown out. 

​The growth ring on the hoof below is not as significant as the picture above,  but it is indicative of a tighter hoof wall connection as well. In this horse's case, it was a new living environment and diet that allowed more frequent correct trimming that caused it. While his hoof health was already good, the connection was able to improve creating the growth ring you can see just above the halfway point of his hoof wall. 
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Some people call these rings "event lines", and this is probably a more aptly named term, as they apply to an event that changed the connection of the hoof wall for some reason. These events can be more effective trimming methods, diet or living environment changes, health changes in the horse that affect hoof wall connection and more. 

My goal with this post was to answer the question of: "Are these growth rings indications of a laminitis event?" This is a question I get asked often, and hopefully with just the little bit of hoof knowledge I shared in this post it should help to clear things up. If you are looking to further your knowledge of the hoof check out our Online Hoof Anatomy, Theory and Barefoot Trimming Course. This course provides an in depth study of hoof anatomy and function and is a beginners guide to learning how to trim their own horse. 

​If you liked this post comment below or share it on our favorite social media app! I would greatly appreciate it. 

​Have a suggestion for a future blog topic? Email me!
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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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What does Founder look like?

7/7/2015

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Published in Saddle Up Magazine August 2015


In last month’s article I discussed the difference between Laminitis and Founder. I explained that laminitis by definition is inflammation of the lamina in the hoof. The lamina affected are the sensitive lamina (surrounding the front and sides of the coffin bone) as well as the solar corium (the underside of the coffin bone). I also discussed that low grade laminitis left untreated, or during acute laminitis, the coffin bone can rotate within the hoof capsule becoming foundered. Founder is simply the rotation of the coffin bone. There is no almost or partly foundered. Either the bone is rotated or it is not. However, the severity of the rotation can vary. This is dependent of the overall health of the hoof prior to the laminitis, the length and severity of the laminitic episode as well as the current trimming/shoeing protocol. In this issue I want to show you what a foundered hoof looks like both inside and out.

In order to demonstrate a foundered hoof, I will first show you a healthy one. The hoof wall is well connected all the way from the coronary band to the ground, it is not flared, pulled forward, or separated.
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In a foundered hoof the wall at the coronary band will start out at a healthy angle, even if it’s just for a 1/4 of an inch. As it descends it will abruptly change angle and flare forward. The lamina will be stretched or separated and the hoof wall will be flared. There are occasions where a wall can simply flare and not be foundered, in these cases the angle change is less abrupt and usually there will be more than one deviation. 
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While it is extremely important to seek veterinary attention in the event of a laminitic event, it is also important to have your veterinarian x-ray your foundered horse and work closely with your farrier/trimmer in order to determine the severity of the rotation and how to correctly trim the hoof to alleviate pain and allow a healthy hoof to grow in. Founder is very serious but often times can be repaired. You must first understand how and why your horse developed the laminitis that lead to the founder, and remove all future triggers. This usually means working closely with your veterinarian to determine blood glucose levels, hormone levels and ruling out other various disease that can facilitate laminitis. Second you must have a competent trimmer/farrier that understands the condition of the hoof and can trim to alleviate the rotation and grow in a healthy well connected hoof wall from the coronary band down. This rehabilitation process can take 6-12 months depending on the severity and how fast the individual horse’s hoof grows. Often the horse can return to light work well before rehab is complete, but it is dependent on the individual case and I would strongly recommend to consult your veterinarian and farrier/trimmer first.
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Laminitis or Founder, Two terms that are often used interchangeably, but do you know the difference?

7/7/2015

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Published in Saddle Up Magazine July 2015

            The terms Laminitis and Founder are often used interchangeably by vets, farriers, trimmers and horse owners alike, however in my opinion they have two very different meanings. Laminitis is the inflammation of the sensitive lamina surrounding the coffin bone. This includes the sensitive lamina, found along the front and sides of the coffin bone, as well as the solar corium which is found on the bottom of the coffin bone. The sensitive lamina is the vasculature covering the coffin bone and it has nerves and a blood supply. The insensitive lamina is located on the inside of the hoof wall and has no blood supply or nerves and is semi-rigid in structure. The sensitive and insensitive lamina interlock like Velcro. This connection of the lamina supports the coffin bone’s position within the hoof.

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The sensitive lamina surrounding the coffin bone after the wall is removed.
        There are two kinds of Laminitis, Acute and Chronic (Founder). Acute Laminitis is when the sensitive lamina becomes inflamed and the blood vessels swell. This causes pain because they are interlocked between the leaflets of the insensitive lamina that are semi-rigid and this connection doesn’t leave room for swelling. The solar corium can also become inflamed during the acute phase and cause bruising and eventually abscessing. A horse with acute laminitis will be extremely tender in their hooves, reluctant to move forward and often adopts a rocked back stance. Acute laminitis will usually last 2-5 days, and must be diagnosed by your veterinarian, who will also likely provide short term anti-inflammatories and care instructions. They should also work in conjunction with your farrier/trimmer to try and alleviate hoof pain and prevent further damaging the hoof. You must figure out what triggered the laminitic attack in the first place in order to prevent it from happening again. There are many causes for acute laminitis, some of the common ones are: carbohydrate overload (excess grain, green grass), hormonal changes (mares cycling in the spring), excess concussive forces (increased work on hard ground), over trimming, adverse reaction to medications, systemic infections, and stress.
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Comparison of hoof wall attachment. Left: healthy Right: foundered
Chronic Laminitis or Founder as it is typically called, is the rotation and or sinking of the coffin bone within the hoof capsule. A horse can have acute laminitis and not founder if the triggers are removed quickly enough and the lamina heals. However, if the cause for the laminitis is not removed and the hooves are not properly trimmed and protected the horse can continue to suffer damage to the sensitive lamina which eventually lets go of the connection with the insensitive lamina, allowing the coffin bone to rotate and sink within the capsule. Whether it rotates one degree or ten, any rotation or sinking at all is classified as founder. Once the lamina separate they cannot be immediately reattached, but the connection can be regrown down from the coronary band as new hoof wall grows in. You will have to work closely with your farrier/trimmer in order to allow the hoof wall to grow in well-connected again, and often a shortened trimming cycle is necessary. It is a long process to rehabilitate a foundered hoof but it is possible.

            Founder is very common, and many horses live and even compete on foundered hooves without their owners knowing it. It’s not until these “timebomb” hooves eventually cause lameness that owners become aware. This is why education and knowledge become so important to the horse owner. Learn to understand what you are looking at when examining your horse’s hooves and how to evaluate their hoof health to prevent and avoid these types of problems in the long run.
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The typical rocked back stance of a horse with acute laminitis
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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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